Georgia to include gender-affirming health care in state Medicaid program

Brooke Migdon
·3 min read

Story at a glance

  • Georgia’s Medicaid program will begin covering gender-affirming surgeries for transgender beneficiaries as part of a settlement with two transgender women.

  • A lawsuit filed last year by the ACLU and the law firm King & Spalding alleged that Georgia Medicaid’s exclusion of coverage for gender-affirming surgery violated the constitutional rights of transgender Medicaid beneficiaries, the Affordable Care Act and the federal Medicaid Act.

  • At least nine other states have rules in place which ban transgender adults from receiving gender-affirming health care under Medicaid.

Georgia’s Department of Community Health has agreed to include coverage for gender-affirming surgeries in the state’s Medicaid program as part of a settlement with two transgender women, the American Civil Liberties Union (ACLU), which had been representing the women, announced this week.

The ACLU and its Georgia affiliate sued the department last year over its categorical exclusion of coverage for gender-affirming surgery, alleging that the rule violated the constitutional rights of transgender Medicaid beneficiaries, as well as the Affordable Care Act and the federal Medicaid Act.

The lawsuit, also filed by the law firm King & Spalding on behalf of Shon Thomas and Gwendolyn Cheney, claimed that Georgia Medicaid had discriminated against the women because they are transgender. Both women are Medicaid beneficiaries diagnosed with gender dysphoria that were denied coverage for gender-affirming surgical care.

The state “incorrectly” characterized the health care needs of both women as “cosmetic” and “experimental,” even through the broader medical community has recognized gender-affirming surgery as an effective treatment for gender dysphoria in adults, according to the complaint, which was initially settled in late April following court-facilitated mediation.

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According to the ACLU, the removal of Georgia Medicaid’s exclusion will take up to a few months to implement, but transgender beneficiaries should now be able to apply for coverage for gender-affirming surgery through their providers.

The group added that the state’s coverage of gender-affirming medical care is a move that is certain to “save lives.”

“Gender-affirming surgeries are safe, effective, and medically necessary,” Taylor Brown, a staff attorney with the ACLU LGBTQ & HIV Project, said Monday. “The ability to obtain gender-affirming surgical care, regardless of socioeconomic status, is an important factor in eliminating systemic health disparities and inequities that many transgender people face.”

Georgia’s Department of Community Health said it had no comment on the settlement.

Until now, Georgia was one of 10 states that expressly ban transgender adults from receiving gender-affirming health care under Medicaid. Exceptions include Ohio, where officials have said the ban is not being enforced, and Arkansas, whose 2021 Medicaid ban only applies to minors.

Florida’s Agency for Health Care Administration (ACHA) is currently considering whether to block the state’s Medicaid program from covering gender-affirming medical care, including puberty blockers, hormones, gender-affirming surgeries or “any other procedures that alter primary or secondary sexual characteristics” when those interventions are used to treat gender dysphoria.

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